Provider Demographics
NPI:1730206038
Name:FIVE STAR HOME HOSPICE, INC.
Entity type:Organization
Organization Name:FIVE STAR HOME HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EBRUY
Authorized Official - Middle Name:K
Authorized Official - Last Name:ARABYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-791-1764
Mailing Address - Street 1:1028 N LAKE AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-4570
Mailing Address - Country:US
Mailing Address - Phone:626-791-1764
Mailing Address - Fax:626-791-5362
Practice Address - Street 1:1028 N LAKE AVE STE 106
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-4570
Practice Address - Country:US
Practice Address - Phone:626-791-1764
Practice Address - Fax:626-791-5362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANON YET251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based